Experts recommend eating what you can

By Elayne Smith Lowe

Cancer does not have hard and fast rules in how it affects someone, or what kind of side effects will come from battling it. One thing though is sure: Despite the nausea, emotional turmoil and exhaustion, patients still need to eat.

However, the question of what to eat may be an unanticipated challenge.

During cancer treatment, comfort foods may no longer bring the same comfort as patients may experience changes to their sense of smell and taste alongside possible appetite loss and nausea.

Joyce Rubinfeld, a treatment nurse and patient educator at Christus St. Vincent Regional Cancer Center, compared it to pregnancy symptoms.

“Someone may not just lose their taste for things they enjoy, but it can be that they get a taste for things they hated,” Rubinfeld said.

While these changes often go away after treatment, they often require some adjustment. For caregivers and friends who want to bring meals or

invite a patient over for dinner, Rubinfeld said having open communication with the patient and flexibility is a key part of providing them support.

“Keep an open mind about what they’re eating,” she said. “One day you think you have it figured out, then the next day or week they don’t want to see that food again.”

Rubinfeld said taste changes are more likely to happen right after a cycle of treatment. So if there are special events, such as birthday or dinner parties, scheduling it just before the next treatment cycle may enable a patient to better participate.

As for the patients, Rubinfeld said even if they are experiencing embarrassing side effects, such as diarrhea or constipation, requesting specific meals from friends or family can help them avoid foods that make them feel worse and guarantee they receive foods they actually want.

“We try not to restrict diets from a medical perspective,” she said. “You must go with what that individual patient’s experience is.”

During the tough days when symptoms are flaring, Rubinfeld said a patient just needs to focus on eating whatever they can manage.

“They should eat whatever is appealing to them so they keep their weight up,” she said.

Katherine Berkowitz, a registered dietitian contracted with Christus St. Vincent’s Cancer Center, said it’s ideal for patients to have balanced meals whenever possible, but it’s much more important to just eat. She said stressing about whether they are eating the right or wrong things is not a priority when they aren’t feeling well.

“There may be times during treatments when a patient has a good appetite and they should try to eat plenty during those times to help make up for days when they cannot eat as much,” Berkowitz said in an email.

She recommends patients adapt their eating schedules if they are unable to consume three big meals a day, and instead switch to six smaller meals or snacks. Anyone bringing food should consider packing meals in small containers to account for appetite loss, she said. At the same time, don’t wait around for them to indulge in the meal, she added.

“Don’t take it personally if they are unable to eat the food you bring them,” she said. “As caregivers, we want our loved ones to eat because we want them to be strong and it’s a way to show our love. But sometimes it can cause tension if you push too hard. Remember, they are trying.”

Berkowitz is a leukemia survivor herself, and said patients need to remember not to be too hard on themselves.

“When you are feeling ill and barely eating, it’s ok to eat anything that you can,” she said. “When you feel good or finish treatment, that is the time to meet with a registered dietitian to go over what a healthy diet is for you and your health conditions.”

Tips for caregivers when it comes to food:

• Make small portions of food and put them in freezable containers:

Due to taste changes, patients may not like the same food after a different treatment cycle. Packing a smaller portion of a meal can ensure they aren’t faced with a fridge full of food they can no longer stomach as well as making it easier to microwave when they are able to eat.

• Don’t ask if a patient wants help, just give it:

Show up with packaged meals instead of asking if they want it so it relieves any feelings about being a burden.

• Clean up if you cook in their kitchen:

Maybe you’ve decided to make an endearing dinner for two at their house, and they love it. Just make sure you don’t leave the patient with dirty dishes because they may not have the strength to clean it.

Create care baskets with a variety of bland food offerings to counter taste changes.

Solid foods such as saltine crackers can be a blessing when a patient is barely able to eat. Dry soup mix or even plain chicken broth makes an easy warm meal.

• Gift teas with different flavors and benefits:

Tea can be really soothing. Consider giving a variety of herbal teas that address different needs, such as ginger for stomach issues or lavender for nerves.

• Be flexible with celebrations:

Rescheduling a birthday party or anniversary celebration to a day right before the patient’s next treatment cycle may help ensure they aren’t suffering from as many side effects or developing new shifts in taste.

• Don’t try to push what foods they should and shouldn’t eat:

While encouraging a patient to eat is good, trying to dictate how much or what kinds of foods they eat can have a negative effect. They’re already facing a life-changing diagnosis and this may not be the time to try to alter their eating habits drastically. Instead, be supportive and ensure they eat what they can every day.

Tips for patients when it comes to food:

• Don’t force yourself to attend a meal-centered event:

If you are nervous to go out to eat or to accept an invitation to eat at a friend’s house, suggest something else. Go for a walk, watch a movie or do activities related to common interests instead.